Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

Wednesday, March 28, 2012

My own medical internship was needlessly abusive in terms of sleep deprivation, treatment of interns as chattel by the Chief and some particularly nasty attendings, and the behaviors of some residents who were determined to return the hazing they'd received to the new intern 'plebes.' The abuses ultimately led to high levels of risk to patients. I wrote about my training experiences in my Sept. 2007 post "Metric myopia: does reducing exploitation of medical trainees have 'little effect' on patients?" [1]

However, in those days medical trainees were generally helpless to do anything about it. Most sucked the abuse up without complaining. In some cases they became victims of a form of the Stockholm Syndrome.

(In my case, I picked up and left the hospital after the PGY-1 internship year and went to other hospitals to complete my residency which were, at the time, of better quality and far less abusive. The jarring PGY-1 experience in part informs my writing on healthcare abuses in general at this blog. The original hospital went bankrupt a few years ago; this was no surprise to me.)

At HC Renewal, the posts on "physician learned helplessness" such as here and here in part focus on the effects of postgraduate medical training abuses.

So, whatever the truth and ultimate outcome, you at least have to admire this Resident (or, I should say, ex-Resident), who both sued and put up his own website about the suit, for his tenacity:

A whopping 182 million dollar lawsuit against Tulane/Baton Rouge General Medical Center and various local doctors was filed by former Tulane/Baton Rouge General Internal Medicine Resident, Dr. Eid Amer on March 19, 2012 in the 19th Judicial District Court of Louisiana. Among the counts in this enormous fifty page lawsuit are: breach of contract, fraud, forgery, negligence, defamation, intentional infliction of emotional distress, invasion of privacy, violation of the whistleblower statute and violation of due process.

Dr. Amer, a thirty-year old physician was in his first year of a three-year categorical internal medicine residency program when he suffered retaliation from his program superiors after submitting a series of complaints regarding medical negligence, defamation, fraud and forgery that culminated in his retaliatory discharge just over two weeks from his last complaint to the CEO of the hospital William Holman who did nothing about it, the complaint alleges.

Details of the issues are at the website. They focus on Dr. Amer's whistleblowing about violations of the 80-hour-per-week rule instituted after the Libby Zion affair (the "Libby Zion law"), retaliation for complaints about the violations, psychological abuses of the trainees that sound all too familiar, and patient care risks (e.g., as detailed in this long page).

The Complaint docket is available in PDF at this link: Eid Amer, MD vs. Baton Rouge General Medical Center, General Health System, Tulane Univ. School of Medicine, and a host of individual plaintiffs.

This is certainly speaking out against the ingrained abuses of the medical training system.

I cannot comment on the merits of this case, but can say from my own personal experience, and that of many colleagues, that the claims are certainly plausible.

I wish this doctor luck. He will need it.

-- SS

[1] I could not at first locate that old post. However, I remember so vividly being compelled - at explicit threat of career jeopardy - as a PGY-1 to do pelvic exams in the middle of the night on disabled febrile female patients from the Inglis House nursing home in Philadelphia (for the mentally normal but severely physically handicapped) with UTI's, pneumonia and other problems, that a search on "pelvic exam" brought the post right up. One does not easily forget experiences like that.

6 comments:

Anonymous
said...

Sadly we as patients see this behavior all the time. Rushed and simply trying to stay even doctors often revert to behavior they experienced in the past or during their training, talking to patients as if they were subordinates there only to do the doctor's bidding.

A couple of weeks ago a post on another blog highlighted a doctor's concern after a patient refused an invasive test and was told by the attending that their insurance would refuse to pay for their stay unless they complied. Checking the doctor found this to be a common myth as the insurance will pay. These actions do exemplify the actions of a bully and one has to wonder about the "training" these doctors are receiving.

Dr AmerI am at the same situation in an abusive program in Philadelphia. I would like to take legal action against program. Can you please let me know about the process a bit more. Did you go to a usual lawyer or one that was specialized in these cases? Also did you talk to AMA local office or anybody else?Thanks for writing about this and for bringing up this issue.

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